A different hair restoration meeting:   The WAHRS Live Surgery Workshop and Symposium by James Arnold, MD, San Jose, California

The World Association of Hair Replacement Surgeons is a newly formed group of experienced surgeons. Its goal is the exchange of advanced ideas and techniques in all forms of surgery applied to hair restoration. The mission of the WAHRS is to augment the exchange of information, not to compete with exist-ng organizations such as the ISHRS, AAFRS, AACS, ASHRS, and others. The 2nd Annual WAHRS meeting was held Feb. 23-26, 1996. in Orlando, Fla.

The meeting's sponsor, the American Academy of Aesthetic and Restorative Surgery, challenged the WAHRS to produce a teaching symposium that would be different from the usual "hair meeting."

Organized by chairman Matt L. Leavitt, DO, the WAHRS meeting succeeded in meeting the challenge, and did so in dramatic fashion. The program centered on a number of well-known surgeons from around the world. The renown surgeons were invited to lecture on their areas of expertise and perform live surgery demonstrating their techniques. Lectures began at 7 a.m., with three or four surgeons describing particular surgical approaches. At 9 a.m., the same surgeons demonstrated the techniques in live surgery. Several more surgeons lectured at noon during lunch. The afternoon sessions featured two or three live surgeries.

With two sets of lectures and two sets of live surgery, the 10-hour days were long but filled with learning opportunities. The format of having a surgeons explaining what they plan to do and why, followed by demonstrations in live surgery, provided an intense learning experience for the three-and-a-half-day meeting.

In all, 18 surgeons lectured and performed 15 live surgeries, either individually or in teams. The lectures presented and surgeries performed included several methods of micro- and mini-grafting; a megasession with Drs. Paul Rose and Ron Shapiro; eyebrow and eye lash transplantation by Dr.Marcelo Gandelman of Brazil; a transplant of a woman with F.P.B. by Drs. Paul Cotterill, Lee Laris and Brad Kurgis; creation of a beautiful front forelock by Dr. Michael Beehner; a transplant of an African-American patient by Drs. Kurgis and Calderone; a Brandy-style scalp lift with preservation of the occipital neurovascular bundle by Dr. Tony Mangubat, with assistance from Dr. Carlos Puig; a neatly performed U-shaped scalp reduction by Dr. Matt Leavitt; corrective surgery on a man with a scattered large grafts in the anterior scalp; insertion of extenders on two patients and demonstrations of the creative triple-flap slot correction on a third patient by Dr. Patrick

Frechet, with assistance from Dr. Puig; and laser transplants by Drs. Marc Avram and Craig Zeiring. Has there ever been a meeting with the depth and breadth of live surgeries as that described here? There were also lectures and demonstrations on anesthesia by Dr. David Seager; hairline design by Dr. Arturo Sandoval, precisely and accurately cutting narrow donor strips, the various ways to cut grafts from donor tissue, an excellent outline for pre- and post-op care by Dr. Robert Leonard, and a thorough review of scalp anatomy by Dr. Jordon Zuckerman.

Panel discussions and individuals also addressed subjects outside the operating room, such as OSHA and CLIA regulations, emergency protocols, medical-legal issues, artificial hair systems and practice marketing. Dr. Mel Mayer spoke on the results of the first phase of trials with Proscar. A special guest lecture on scarring alopecia was given by Dr. George Farber, who is able to teach and entertain simultaneously. His presentation was well-received. There was also a three-hour seminar for nurse assistants.

It would be impossible to report on everything of importance revealed at this meeting, but three items of special interest are:

Dr. Patrick Frechet uses a five-pronged skin hook intraoperatively to stretch the galea beneath the hair-bearing portion of the scalp. The stretching enables him to excise an extra centimeter of scalp when placing an extender and an extra centimeter of scalp 30 days later when the extender is removed. Those two extra centimeters make a significant difference and arc obtained with little additional surgical time.

The early studies of Proscar, as reported by Dr. Mayor, suggest it really works. Up to 50 percent of men may respond with 10 percent or more regrowth of hair as measured by hair count. Also, the dose required may be very, very small, for example, .05 mg. Yes, 1/1,000 of the dose suggested for prostates!

The official AAARS and WAHRS journal, the International Journal of Aesthetic and Restorative Surgery, devoted its entire December issue to hair restoration. Encouraged by Dr. Matt Leavitt, 14 authors submitted papers that were accepted for publication. The issue contains significant new information of value and interest to hair replacement surgeons. To obtain a copy, contact Kathleen Rutherford, Managing Editor, 17 Carriage Run, Lincoln University, PA 19352; telephone (610) 255-5732; fax (610) 225-5235.

A welcomed aspect of the meeting was its small size. The number of attendees was intentionally limited to about 50. During the three and a half days, everyone had the opportunity to introduce themselves and have detailed discussions with the faculty and each other.

The ORs were open, allowing everyone (the freedom to move around as surgery was performed. A video monitor system was used for many of the cases. The surgeons were wired for sound, allowing a direct flow of questions and answers. During slow portions of the surgeries, attendees were able to have informal discussions in the hallways or conference rooms.

Faculty members were open and freely available to anyone with specific questions or general philosophical queries on hair replacement options. Although the days were long, there was never a lull in the learning and teaching process. A number of the faculty members, durable veterans of many previous hair meetings, said the WAHRS meeting was the most intense learning experience they have encountered.

The credit for the educational value of the the WAHRS meeting and how smoothly it was run goes to Matt Leavitt. He had his share of helpers to be sure, but he was the driving force in assembling the faculty, designing the lecture and live surgery format and ensuring that all aspects of hair replacement were included - from transplanting a single hair to the hairline to major lifts and triple-flap slot connections.

WAHRS plans to have another, similar symposium in early 1997. Again, the number of attendees will be limited. If you are fortunate enough to see the first announcement of the 1997 meeting, apply immediately. Once the word is out, if you wait a week to apply, it may be too late.